Madison Medical Center

All Charges

Charge

Type

Setting

Price

SUB. NURSING FAC. CARE (LIMITED)

Facility

$88.50

Service Code	CPT 99308
Hospital Charge Code	4499312
Hospital Revenue Code	525
Rate for Payer: Cash Price	$79.65

SUB. NURSING FAC. CARE (LIMITED)

Facility

$88.50

Service Code	CPT 99308
Hospital Charge Code	4499312
Hospital Revenue Code	525
Min. Negotiated Rate	$52.39
Max. Negotiated Rate	$173.53
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$52.39
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$63.19
Rate for Payer: Cash Price	$79.65
Rate for Payer: Cash Price	$79.65
Rate for Payer: UnitedHealthcare Commercial	$59.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

SUBSEQ. ACUTE CARE (BRIEF)

Professional

Both

$130.00

Service Code	CPT 99231
Hospital Charge Code	4499231
Hospital Revenue Code	987
Min. Negotiated Rate	$31.75
Max. Negotiated Rate	$45.50
Rate for Payer: Aetna Commercial/Medicare Advantage	$42.91
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Medicaid Managed Care	$31.75
Rate for Payer: Cash Price	$117.00
Rate for Payer: Cash Price	$117.00
Rate for Payer: Cigna Commercial HMO & PPO	$42.91
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$31.75
Rate for Payer: Home State Health Plan Medicaid Managed Care	$34.92
Rate for Payer: Home State Health Plan Medicare Advantage	$42.91
Rate for Payer: Optum Medicare Advantage	$45.50
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$31.75

SUBSEQ. ACUTE CARE (INTER)

Professional

Both

$295.00

Service Code	CPT 99233
Hospital Charge Code	4499233
Hospital Revenue Code	987
Min. Negotiated Rate	$84.01
Max. Negotiated Rate	$103.87
Rate for Payer: Aetna Commercial/Medicare Advantage	$103.87
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Medicaid Managed Care	$84.01
Rate for Payer: Cash Price	$265.50
Rate for Payer: Cash Price	$265.50
Rate for Payer: Cigna Commercial HMO & PPO	$103.87
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$84.01
Rate for Payer: Home State Health Plan Medicaid Managed Care	$92.41
Rate for Payer: Home State Health Plan Medicare Advantage	$103.87
Rate for Payer: Optum Medicare Advantage	$103.25
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$84.01

SUBSEQ. ACUTE CARE (LIMITED)

Professional

Both

$205.00

Service Code	CPT 99232
Hospital Charge Code	4499232
Hospital Revenue Code	987
Min. Negotiated Rate	$58.46
Max. Negotiated Rate	$71.75
Rate for Payer: Aetna Commercial/Medicare Advantage	$68.53
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Medicaid Managed Care	$58.46
Rate for Payer: Cash Price	$184.50
Rate for Payer: Cash Price	$184.50
Rate for Payer: Cigna Commercial HMO & PPO	$68.53
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$58.46
Rate for Payer: Home State Health Plan Medicaid Managed Care	$64.31
Rate for Payer: Home State Health Plan Medicare Advantage	$68.53
Rate for Payer: Optum Medicare Advantage	$71.75
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$58.46

SUBSEQ HOSP CARE INPT EXTENDED

Facility

$282.00

Service Code	CPT 99233
Hospital Charge Code	5499233
Rate for Payer: Cash Price	$253.80

SUBSEQ HOSP CARE INPT INTERMEDIATE

Facility

$195.00

Service Code	CPT 99232
Hospital Charge Code	5499232
Rate for Payer: Cash Price	$175.50

SUBSEQ HOSP CARE MODERATE 25 MIN

Facility

$195.00

Service Code	CPT 99232
Hospital Charge Code	9499232
Hospital Revenue Code	521
Rate for Payer: Cash Price	$175.50

SUBSEQ HOSP CARE MODERATE 25 MIN

Facility

$195.00

Service Code	CPT 99232
Hospital Charge Code	9499232
Hospital Revenue Code	521
Min. Negotiated Rate	$115.44
Max. Negotiated Rate	$173.53
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$115.44
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$139.23
Rate for Payer: Cash Price	$175.50
Rate for Payer: Cash Price	$175.50
Rate for Payer: UnitedHealthcare Commercial	$130.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

SUBSEQ INPT INTERMEDIATED HOSP VISIT

Facility

$105.00

Service Code	CPT 99232
Hospital Charge Code	3999232
Hospital Revenue Code	521
Min. Negotiated Rate	$62.16
Max. Negotiated Rate	$173.53
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$62.16
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$74.97
Rate for Payer: Cash Price	$94.50
Rate for Payer: Cash Price	$94.50
Rate for Payer: UnitedHealthcare Commercial	$70.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

SUBSEQ INPT INTERMEDIATED HOSP VISIT

Facility

$105.00

Service Code	CPT 99232
Hospital Charge Code	3999232
Hospital Revenue Code	521
Rate for Payer: Cash Price	$94.50

SUBSEQ IP VISIT BRIEF

Professional

Both

$130.00

Service Code	CPT 99231
Hospital Charge Code	9799231
Hospital Revenue Code	987
Min. Negotiated Rate	$31.75
Max. Negotiated Rate	$45.50
Rate for Payer: Aetna Commercial/Medicare Advantage	$42.91
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Medicaid Managed Care	$31.75
Rate for Payer: Cash Price	$117.00
Rate for Payer: Cash Price	$117.00
Rate for Payer: Cigna Commercial HMO & PPO	$42.91
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$31.75
Rate for Payer: Home State Health Plan Medicaid Managed Care	$34.92
Rate for Payer: Home State Health Plan Medicare Advantage	$42.91
Rate for Payer: Optum Medicare Advantage	$45.50
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$31.75

SUBSEQ IP VISIT EXTENDED

Professional

Both

$295.00

Service Code	CPT 99233
Hospital Charge Code	9799233
Hospital Revenue Code	987
Min. Negotiated Rate	$84.01
Max. Negotiated Rate	$103.87
Rate for Payer: Aetna Commercial/Medicare Advantage	$103.87
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Medicaid Managed Care	$84.01
Rate for Payer: Cash Price	$265.50
Rate for Payer: Cash Price	$265.50
Rate for Payer: Cigna Commercial HMO & PPO	$103.87
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$84.01
Rate for Payer: Home State Health Plan Medicaid Managed Care	$92.41
Rate for Payer: Home State Health Plan Medicare Advantage	$103.87
Rate for Payer: Optum Medicare Advantage	$103.25
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$84.01

SUBSEQ IP VISIT INTERMEDIATE

Professional

Both

$205.00

Service Code	CPT 99232
Hospital Charge Code	9799232
Hospital Revenue Code	987
Min. Negotiated Rate	$58.46
Max. Negotiated Rate	$71.75
Rate for Payer: Aetna Commercial/Medicare Advantage	$68.53
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Medicaid Managed Care	$58.46
Rate for Payer: Cash Price	$184.50
Rate for Payer: Cash Price	$184.50
Rate for Payer: Cigna Commercial HMO & PPO	$68.53
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$58.46
Rate for Payer: Home State Health Plan Medicaid Managed Care	$64.31
Rate for Payer: Home State Health Plan Medicare Advantage	$68.53
Rate for Payer: Optum Medicare Advantage	$71.75
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$58.46

SUBSEQ NH BRIEF

Facility

$57.00

Service Code	CPT 99307
Hospital Charge Code	5299311
Hospital Revenue Code	525
Rate for Payer: Cash Price	$51.30

SUBSEQ NH BRIEF

Facility

$100.00

Service Code	CPT 99307
Hospital Charge Code	5299307
Hospital Revenue Code	525
Rate for Payer: Cash Price	$90.00

SUBSEQ NH BRIEF

Facility

$57.00

Service Code	CPT 99307
Hospital Charge Code	5299311
Hospital Revenue Code	525
Min. Negotiated Rate	$33.74
Max. Negotiated Rate	$173.53
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$33.74
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$40.70
Rate for Payer: Cash Price	$51.30
Rate for Payer: Cash Price	$51.30
Rate for Payer: UnitedHealthcare Commercial	$38.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

SUBSEQ NH BRIEF

Facility

$100.00

Service Code	CPT 99307
Hospital Charge Code	5299307
Hospital Revenue Code	525
Min. Negotiated Rate	$59.20
Max. Negotiated Rate	$173.53
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$59.20
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$71.40
Rate for Payer: Cash Price	$90.00
Rate for Payer: Cash Price	$90.00
Rate for Payer: UnitedHealthcare Commercial	$66.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

SUBSEQ NH BRIEF VISIT

Facility

$100.00

Service Code	CPT 99307
Hospital Charge Code	9899307
Hospital Revenue Code	521
Rate for Payer: Cash Price	$90.00

SUBSEQ NH BRIEF VISIT

Facility

$57.00

Service Code	CPT 99307
Hospital Charge Code	9899311
Hospital Revenue Code	521
Rate for Payer: Cash Price	$51.30

SUBSEQ NH BRIEF VISIT

Facility

$100.00

Service Code	CPT 99307
Hospital Charge Code	9899307
Hospital Revenue Code	521
Min. Negotiated Rate	$59.20
Max. Negotiated Rate	$173.53
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$59.20
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$71.40
Rate for Payer: Cash Price	$90.00
Rate for Payer: Cash Price	$90.00
Rate for Payer: UnitedHealthcare Commercial	$66.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

SUBSEQ NH BRIEF VISIT

Facility

$57.00

Service Code	CPT 99307
Hospital Charge Code	9899311
Hospital Revenue Code	521
Min. Negotiated Rate	$33.74
Max. Negotiated Rate	$173.53
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$33.74
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$40.70
Rate for Payer: Cash Price	$51.30
Rate for Payer: Cash Price	$51.30
Rate for Payer: UnitedHealthcare Commercial	$38.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

SUBSEQ NH COMPREHENSIVE

Facility

$245.00

Service Code	CPT 99310
Hospital Charge Code	5499310
Hospital Revenue Code	521
Rate for Payer: Cash Price	$220.50

SUBSEQ NH COMPREHENSIVE

Facility

$260.00

Service Code	CPT 99310
Hospital Charge Code	9899310
Hospital Revenue Code	521
Rate for Payer: Cash Price	$234.00

SUBSEQ NH COMPREHENSIVE

Facility

$245.00

Service Code	CPT 99310
Hospital Charge Code	5499310
Hospital Revenue Code	521
Min. Negotiated Rate	$145.04
Max. Negotiated Rate	$174.93
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$145.04
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$174.93
Rate for Payer: Cash Price	$220.50
Rate for Payer: Cash Price	$220.50
Rate for Payer: UnitedHealthcare Commercial	$163.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

Know your out-of-pocket cost for care.

All Charges